外周血清信号蛋白7A在老年急性冠状动脉综合征病人中的表达水平及临床意义  

Levels and diagnostic value of serum semaphorin 7A in elderly patients with acute coronary syndrome

作　　者：刘玄德 周世功 徐祝勤 单守杰[2] LIU Xuande;ZHOU Shigong;XU Zhuqin;SHAN Shoujie(Department of Cardiology,Fengyang County People’s Hospital,Chuzhou 233100,China;Department of Cardiology,Nanjing Hospital Affiliated to Nanjing Medical University,Nanjing 210006,China)

机构地区：[1]凤阳县人民医院心内科,安徽省滁州市233100 [2]南京医科大学附属南京医院心内科,江苏省南京市210006

出　　处：《实用老年医学》2025年第3期294-297,共4页Practical Geriatrics

摘　　要：目的探讨老年急性冠状动脉综合征(ACS)病人血清信号蛋白7A(Sema7A)的水平及临床意义。方法选取2020年1月至2023年10月在凤阳县人民医院心内科住院计划行冠状动脉造影的新发老年ACS病人94例为ACS组,同时选取同期冠脉造影阳性的老年慢性冠状动脉综合征(CCS)病人94例作为对照(CCS组)。采用ELISA法检测2组血清Sema7A蛋白水平,比较2组血清Sema7A蛋白水平的差异,并分析其与炎症因子IL-1β、IL-6、TNF-α和IL-10水平的相关性,并探讨其临床意义。结果ACS组血清Sema7A水平显著高于CCS组(P<0.01)。根据Gensini评分将ACS组病人分为轻度病变组、中度病变组和高度病变组,高度病变组血清Sema7A水平显著高于中度病变组和轻度病变组(P<0.01)。ACS组血清Sema7A水平与IL-1β、IL-6、TNF-α和IL-10之间均存在显著相关性(P<0.01),血清Sema7A水平预测ACS的最佳截断值为6.13 ng/mL,敏感度为72.6%,特异度为78.3%,ROC曲线下面积(AUC)为0.653(95%CI:0.585~0.722,P<0.01)。结论血清Sema7A水平与老年ACS病人冠状动脉狭窄严重程度明显相关,可作为预测老年CCS病人发生ACS潜在的生物标志物。Objective To explore the levels and clinical value of serum semaphorin 7A(Sema7A)in the patients with acute coronary syndrome(ACS).Methods A total of 94 elderly patients with new onset of ACS who underwent coronary angiography from January 2020 to October 2023 in Fengyang County People’s Hospital were enrolled in ACS group,and 94 elderly patients with chronic coronary syndrome(CCS)undergoing coronary angiography at the same period were enrolled as control(CCS group).The level of serum Sema7A was evaluated by ELISA.The correlation between serum Sema7A level and the levels of interleukin-1β(IL-1β),IL-6,tumor necrosis factor-α(TNF-α)and IL-10 was analyzed.The level of serum Sema7A was compared between the two groups and its clinical significance was analyzed.Results The level of serum Sema7A was significantly higher in ACS group than that in CCS group(12.09±8.57 vs 8.65±6.57 ng/mL,P<0.01).According to Gensini score,the patients in ACS group were divided into mild disease group,moderate disease group and severe disease group.The level of serum Sema7A in severe disease group was significantly higher than that in moderate disease group and mild disease group(P<0.01).The level of serum Sema7A in ACS group was significantly correlated with the levels of IL-1β,IL-6,TNF-αand IL-10(P<0.01).ROC curve analysis showed that the optimal cut-off value of serum Sema7A to predict ACS was 6.13 ng/mL with a sensitivity of 72.6%,a specificity of 78.3%and the area under curve(AUC)of 0.653(95%CI:0.585-0.722,P<0.01).Conclusions Serum Sema7A level is significantly correlated with the severity of coronary artery stenosis in the elderly patients with ACS,and it may be a potential biomarker for predicting ACS.

关 键 词：老年人 急性冠状动脉综合征 血清信号蛋白7A 生物标志物 冠状动脉粥样斑块 易损斑块 

分 类 号：R541.4[医药卫生—心血管疾病]